Three-Dimensional Models in Hepatic Surgery: Clinical Outcomes A Single-Center Experience

<b>Background:</b> Hepatic resection requires precise knowledge of vascular anatomy and remnant liver volume to guarantee both safety and efficacy. Three-dimensional (3D) models, either virtual or printed, have been proposed as tools to optimize surgical planning, education, and intraoperative navigation. <b>Material and Methods:</b> This retrospective observational study evaluated the impact of 3D model utilization (virtual and printed), in 89 patients who underwent elective hepatectomy at Infanta Elena University Hospital (Valdemoro, Madrid, Spain) between May 2018 and May 2023. The implementation of 3D modeling began to be routinely implemented as of November 2020. Patients were divided into two groups: those without 3D modeling (<i>n</i> = 40) and those with 3D modeling (<i>n</i> = 49). <b>Results:</b> Baseline characteristics were comparable between groups. Intraoperative blood loss was significantly lower in the 3D model group (median 175 mL vs. 262.5 mL; <i>p</i> < 0.001), with no statistically significant differences in operative time, complication rate (Clavien-Dindo classification), length of hospital stay, or in-hospital mortality. Multivariable analysis identified dyslipidemia, postoperative sodium delta, and postoperative increase in direct bilirubin as independent risk factors for complications, whereas albumin demonstrated a protective effect. <b>Conclusions:</b> Three-dimensional modeling improves anatomic orientation and reduces intraoperative blood loss, although it does not significantly modify classic perioperative outcomes. Its principal value appears to reside in preoperative planning and technical safety rather than direct clinical impact.